Trial of relaxation in reducing coronary risk
Trial of relaxation in reducing coronary risk
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放松降低冠状动脉风险的试验
DOI：
10.1136/bmj.290.6483.1746-c
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
M. Marmot
中科院分区：
文献类型：
--
作者：
C. Patel;M. Marmot
先生，-今年伊斯兰斋月的罗莎斋戒从5月21日开始，持续一个月。在日出和日落之间，禁止进食、饮水和使用药物，但对于糖尿病等特殊疾病，患者可以自行决定是否服用药物。英国有超过1500万穆斯林，因此在这段时间内，对相当数量的病人的医疗可能会中断。目前，我们正在研究亚洲妇女健康教育的各个方面。虽然这项调查是不完整的，它是适当的传达一个警告注意药物方案在这几个星期的禁食。在我们的调查中，44名穆斯林妇女正在接受治疗，无论是从他们的家庭医生或医院门诊部的各种疾病。这些妇女中有37人说她们在斋月禁食，5人不禁食，2人有时禁食。在禁食组中，只有7名患者表示他们继续在规定的时间服用药物。30例未依从的患者要么漏服剂量（25例患者），要么更严重的是，在一次单次给药中服用了当天的所有药物（5例患者）。后一种做法显然具有潜在的危险。在那些省略剂量的患者中，18名患者在早上或晚上只服用一剂，而7名患者只服用两剂，一剂在清晨，另一剂在深夜，禁食期以外。虽然我们的研究结果是初步的，但它们清楚地强调了这些禁食和吸毒方法中固有的几种可能的危险。首先，药物的适当治疗浓度不能维持必要的时间，并且在一次消耗一整天供应的患者中将超过。其次，在后一组中，毒性反应和药物相互作用的危险大大增加。显然，医生应该意识到在这段时间内他们的Moselm患者中这些做法的可能性，并在适当的时候，建议不要以这种方式省略或合并剂量。M ASLAM M A HEALY
SIR,-This year the Islamic fast of Rosa in Ramadan started on 21 May and lasts for one month. Between the hours of sunrise and sunset the intake of food and drink and the use of medicines is prohibited-although drugs may be taken at the patient's own discretion for specific illnesses such as diabetes. There are over 1 5 million Moslems in the United Kingdom, so the medical treatment of an appreciable number of patients may be disrupted during this time. Currently we are examining aspects of health education among Asian women. Although this survey is not complete, it is appropriate to convey a cautionary note about drug regimens during these few weeks of fasting. In our survey 44 unselected Moslem women were undergoing treatment from either their GP or the hospital outpatient department for a variety of ailments. Thirty seven of these women said they fasted in Ramadan, five did not fast, and two sometimes fasted. In the fasting group only seven patients said they continued to take their medicines at the prescribed times. The 30 patients who did not comply either missed doses (25 patients) or, more seriously, took all their medicines for that day in one single dose (5 patients). This latter practice is clearly potentially dangerous. Of those omitting doses, 18 took only one dose in either the morning or evening while seven patients took only two doses, one in early morning, the other in late evening, outside the fasting period. Although our results are preliminary, they clearly highlight several possible dangers inherent in these approaches to fasting and drug taking. Firstly, the appropriate therapeutic concentration of drug is not maintained for the requisite period and will be exceeded in the patient who consumes a whole day's supply at once. Secondly, in this latter group the dangers of toxic reactions and drug interactions are greatly enhanced. Clearly, doctors should be aware of the possibility of these practices among their Moselm patients during this time and, when appropriate, advise against omitting or combining doses in this way. M ASLAM M A HEALY